Home Alzheimer's Disease When Should Someone with Dementia Move to Assisted Living?

When Should Someone with Dementia Move to Assisted Living?

by Derrick
dementia and assisted living

According to the Alzheimer’s Association, around 16 million Americans dedicate their time to taking care of a family member with dementia. While it is good for these people to devote themselves to their loved ones, it can be a burden to ensure home health care without falling sick or affecting their careers.

More importantly, time will come when the increasing needs of dementia patients exceed our capabilities. Even relying on caregivers is just a temporary solution. It is the time when we have to carefully consider moving a loved one into an assisted living facility.

But when should people with dementia move to assisted living facilities?

Every patient is different, so there is no specific guideline to follow when deciding if it’s time to move them to a facility. However, according to experts, the following are the most common signs that call for a shift from home care to assisted living.

Escalating Care Needs for ADLs

Dementia patients are very prone to falling. Their cognitive impairment makes them unable to perform any ADLs (Activities of Daily Living). As the term implies, it refers to the six basic human skills:

  1. eating,
  2. bathing,
  3. going to the bathroom,
  4. dressing,
  5. grooming (i.e., maintaining personal hygiene),
  6. and mobility.

Not only ADLS but doing IADLs (Instrumental Activities of Daily Living) can be a challenge for patients with dementia. While ADLs are basic self-care tasks, IADLs are more complex skills. These activities include the use of appliances, cooking, housekeeping, money management, shopping, leisure activities, and medication management.

Having minimal mobility at home can be risky for a dementia patient, even with a caregiver’s help. For example, a 70-year-old man can easily hurt himself trying to get his 180-pound sick wife to the toilet two or three times every day. Caregivers get stressed, too. Dealing with dementia patients might be their forte, but doing it alone can be very taxing.

Conversely, assisted living communities are equipped with facilities intended for dementia patients, which are far better than your own home. They are primarily designed to support dementia patients and prevent them from getting into any accident 24/7. If you are putting you and your caregiver’s overall well-being at risk, it’s time to give an assisted living residency a call.

Increased Aggression

People with dementia are more apt to bite, hit, or kick an individual. Their physical aggression, however, is often in response to their fear and helplessness. One of the best ways to deal with their aggression is to figure out its cause, which commonly involves pain, wandering mind, and other triggering factors.

However, here’s the thing: caregivers and family members cannot engage in an argument with dementia patients nor force any issue that makes them more aggressive. They might misunderstand your sincerity. Softly talking to or calming them down can agitate them even more, and gently rubbing their hands might result in them taking a swing.

What’s more, not only physically, but they could be sexually aggressive, as well. Forced restraint might occur, but only when there is absolutely no other choice—of course, you don’t want to resort to this.

If your beloved elder is regularly exercising physical, sexual, or violent aggression, the best course of action is to consider assisted living placement. Their facilities and staff are well-trained to cope and handle these situations professionally.

Increased Wandering

Seniors tend to wander during the later stages of dementia. Like ordinary people, they wander because they might be looking for something, feeling bored, having the urge to do something, or doing a daily routine. It can also be a result of an unpleasant emotion or a reaction to an overstimulating disturbance, like when they are aggressive.

The problem is seniors with dementia react unpredictably, which can pose life-threatening situations to themselves. One of the worst cases that could happen is when they wander outside, forget how to find their way back, and get injured someplace unknown and unreachable.

However, you cannot forbid them from wandering. It is in a dementia patient’s nature. The more you prevent them from wandering, the more they will do it. You would want them to stay in a place where they are not restricted and, at the same time, safe from any potential accidents.

An assisted living community offers particular security to elders, allowing them to move about within the building without the risk of getting lost or injured. Every corner of the facility is heavily monitored either by technology or employees. Hence, the response time whenever an elder gets lost or injured from moving around is also significantly increased. 

Increased Sundowning

Agitations and confusions experienced by dementia patients are less pronounced earlier in the day and get worse during late afternoons or evenings. This symptom is called Sundowners syndrome, which is also referred to as “late-day confusion.” It is one of the main reasons why dementia patients act aggressively and end up wandering.

Related article: What is Sundowning and How Can You Prevent It?

Sundowning is a typical symptom of dementia. It is a symptom that consists of several other symptoms. It can cause dementia patients to pace around, ignore directions, be confused, anxious, and violent. While factors like fatigue, internal clock disruption, or urinary tract infection can aggravate sundowning, its exact cause is still unknown.

Experts think that sundowning can be eased with sun exposure combined with a low dose of melatonin, which is a naturally occurring hormone responsible for one’s sleep-wake cycle. Unfortunately, this is not always effective. Sundowning will continue to severely disrupt family routines and take a heavy toll on caregivers.

The safest place dementia patients can stay at is in a care facility, where residents are closely monitored. However, sundowning can still occur in assisted living communities. For example, medical staff arriving at and leaving the facility can give elders a cue to do their past routines, such as going home or checking out their children.

But as mentioned, assisted living facilities are designed to secure dementia patients and give them the environment they can be safe and fit in. Rest assured, every resident feels a feeling of freedom, while, at the same time, experience an appropriate level of security.


It is hard to move our loved ones into assisted living. Not only do we consider the emotional toll it gives, but financial considerations can also weigh heavily on our minds. Although there are no drawbacks to placing a loved one in a facility too soon, there are many disadvantages that both the family and the patient with dementia could encounter when waiting too long.

If now is not the right time, you may find ways to keep your loved one at home longer. Those steps may just delay the inevitable, but they can help both the individual and the caregiver. Sometimes, however, assisted living is the answer to keep elders happy, safe, and secure while living their lives.

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